Endometriosis

Endometriosis is a gynecological disorder where endometrial tissue that lines the uterus grows outside the uterus.

The most common areas for endometriosis to grow outside the uterus are in the abdominal lining behind the uterus and the ovaries. Approximately 5% of women have endometriosis, but in women with infertility it may be as high as 50%. If your mother or sisters had endometriosis you are at higher risk of having endometriosis.

Symptoms of Endometriosis

Some common symptoms of endometriosis are pelvic or abdominal pain, pain with intercourse, and painful menstrual periods. Some patients with endometriosis have significant pain, while others have limited or no pain. Your doctor will take your medical and family history and perform a physical examination to see if you have signs of endometriosis such as an enlarged ovary or nodules of endometriosis on pelvic examination.

Treatment of Endometriosis

The only way to make a definite diagnosis of endometriosis is by seeing and removing the endometrial tissue. This requires an outpatient procedure called a laparoscopy where small tubes containing a camera and instruments are placed into the abdomen through small incisions in your skin. In women who have an indication for a laparoscopy, removing or destroying the endometriosis has been shown to improve pregnancy rates compared to women whose endometriosis was not removed or destroyed.

In addition to surgical treatment of endometriosis there are a number of medical treatments that will help with the amount of pain the patient feels from their endometriosis. The most effective and well studied medical treatment is Lupron, an injectable medication that stops the patient’s menstrual cycles and puts the patient into a temporary state of menopause so that the endometriosis stops growing and goes away. Unfortunately for patients trying to conceive, this treatment also stops ovulation (development and release of eggs) from the ovary. For women with endometriosis who are trying to conceive, they will have to make a choice to delay conception in order to use the medications to help them control their pelvic pain.

Endometriosis & Infertility, What’s the Connection?

Endometriosis is often related to infertility, although some women with endometriosis have no difficulty conceiving.

For women with endometriosis and infertility, the common fertility treatments will improve your chance of getting pregnant. These treatments include medications to increase the number of eggs your ovaries produce each month, with or without intrauterine (artificial) insemination with your partner’s sperm, or in vitro fertilization (IVF).